What are the potential indications for intubation, what signs & symptoms are of relevance to airway management in burns, and what special considerations may you need to make in airway management?
Potential indications:
Airway obstruction (or high risk of developing airway obstruction)
Respiratory distress requiring ventilation
Reduced conscious level
Need for transfer in major burns
Important signs & symptoms suggesting potential airway injury:
Facial burns
Voice changes/hoarseness
Stridor
Perioral/intraoral soot
Special considerations in airway management:
Prepare for a difficult airway – there may be early airway swelling
Ensure backup plans, including smaller ETTs and FONA
Consider advanced techniques e.g. AFOI
Inhalational injury and respiratory distress
In concurrent trauma, there may be a need for cervical spine stabilisation
Use an uncut ET tube – this allows for evolving swelling of the tissues
Ideally larger diameter to facilitate bronchoscopy
